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The authors describe a case of Noma or Cancrum Oris, an oral gangrenous disease, features more frequently found in children from developing countries. The clinical features, its ethiopathogenesis, and its particular link with different geographic and economic areas of the world, its clinical evolution as well as surgical treatment are all discussed. Underlined is the functional and organic aspect of this disease, in particular the distortion of the face, which commonly involves the full thickness of the cheek skin and bone, mandibular ankylosis and craniofacial dismorphisms, and the modern approach in reconstructive microsurgery. The authors report a case of a patient affected by Noma, with a very evident left face dismorphism, where we found a brilliant solution using a left radial forearm fasciocutaneous free flap, appropriately shaped.
The authors, after a careful review of the scientific literature and on the basis of biophysical concepts with their own experience, conclude that high-intensity ultrasounds (US) are responsible for some biological lesions, which are partly unknown. US can cause burns and skin necrosis; thus, our employment of this technique must be correct, justified, and practiced very carefully and shrewdly and its advantages versus traditional liposuction must be reviewed.
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